Provider Demographics
NPI:1225261217
Name:NEWTON H BULLARD, MD LLC
Entity Type:Organization
Organization Name:NEWTON H BULLARD, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEWTON
Authorized Official - Middle Name:H
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-232-0011
Mailing Address - Street 1:7685 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4216
Mailing Address - Country:US
Mailing Address - Phone:513-232-0011
Mailing Address - Fax:513-232-8434
Practice Address - Street 1:7685 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4216
Practice Address - Country:US
Practice Address - Phone:513-232-0011
Practice Address - Fax:513-232-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3003985Medicaid
OH3003985Medicaid